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Satoko Fujimoto, Yasushi Ikuno, Yukari Jo, Kaori Sayanagi, Kohji Nishida; Long-term Postoperative Results in Vitrectomy for Myopic Foveoschisis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2710.
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© ARVO (1962-2015); The Authors (2016-present)
Myopic Foveoschisis (MF) is one of the major causes of visual loss in highly myopic patients, and vitrectomy is a common treatment. We investigated 2-year -postoperative results of vitrectomy for MF.
Sixty-five eyes with 58 patients that underwent vitrectomy for MF, were included. The surgical procedures included internal limiting membrane (ILM) peeling and gas tamponade, and cataract surgery was performed in all 43 phakic eyes. The eyes were divided into three groups depending on the preoperative foveal microanatomy in optical coherence tomography (OCT) images: foveal detachment type (FD, n=30) , retinoschisis type (RS, n=22) , and macular hole type (MH, n=13). We defined high myopia as a refractive error greater than -6.0 diopters or an axial length exceeding 26.5mm. Best-corrected visual acuity (BCVA) and optical coherence tomographic (OCT) findings were compared among groups, preoperatively and 3, 6, 12, 24 months postoperatively.
Patients age at surgery ranged from 43 to 83 years old (mean 65.0±9.7 years). The refractive error ranged from -3.0D to -25.0D (mean -13.0±4.5D) in the 43 phakic eyes, the axial lengths from 25.7 to 34.6mm (mean 29.4±1.7mm), and duration of symptoms from 0.5 to 168 months (mean 16.5±28.7months). Mean preoperative logMAR value was 0.89 in FD group, 0.84 in RS group, and 0.87 in the MH group. There was no significant difference among three groups in such preoperative data as age, sex, lens status, refractive error, axial length, duration of symptoms, and logMAR value by one-way analysis of varianve (ANOVA). Preoperative logMAR value was correlated with neither duration of symptoms nor axial length. FD group (P<0.01) and RS group (P<0.05) maintained significantly improved vision after 24 months, although not in MH group. Macular holes were re-opened in 3 eyes of the MH group, however no other severe complications have occurred. Mean 24 months -postoperative logMAR value was 0.59 in FD group, 0.68 in RS group and 0.75 in MH group, which were not significant among three groups. Postoperative logMAR value in overall groups was correlated with age (P<0.05) and preoperative logMAR value (P<0.01).
Vitrectomy for MF is relatively safe and effective for two years postoperatively, except in MH group. Age and preoperative BCVA are key factors determining postoperative visual outcome.
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